Senate Bill S1877

                                 
BILL NUMBER: S1877

SPONSOR: BROUK
 
TITLE OF BILL:

An act to amend the public health law, in relation to requiring the
department of health to develop and maternal health care providers to
distribute written information about episiotomy to maternity patients

 
PURPOSE OR GENERAL IDEA OFBILL:

To amend the public health law, in relation to informing maternity
patients about the risks associated with episiotomies.

 
SUMMARY OF KEY PROVISIONS:

Section one amends the public health law by adding a new section

§ 2500-m. Subdivision one provides definitions and establishes a proce-
dure for a maternal health provider to provide a written communication
to each pregnant woman for whom a vaginal delivery is planned. Subdivi-
sion two provides that the Commissioner of Health shall consult with the
              

American College of Obstetricians and Gynecologists and the New York
State Association of Licensed Midwives to develop a written communi-
cation or communications for maternal health care providers to distrib-
ute to patients as required under this section.

Section two provides the effective date.

 
JUSTIFICATION:

Both the American College of Obstetricians and Gynecologists (ACOG) and
the World Health Organization (WHO) have recommended against the routine
use of episiotomies for decades. Experts today agree that episiotomies
are rarely ever medically necessary, can cause additional postpartum
pain and injury, and increase the overall risk to mothers. Because of
this, experts say that the national average rate should be 5 percent,
yet in 2017, the national average was more than double the ideal rate at
12 percent.

The average episiotomy rate in 2017 for all NYS hospitals was 10.4
percent, a rate lower than the national average but still substantially
higher than ACOG and WHO recommendations. Within the state episiotomy
rates vary greatly. In fact, in 2017 one hospital had one of the highest
episiotomy rates in the country and the highest in New York State at a
rate of 65.2 percent with 748 women receiving an episiotomy out of 1,886
total births. In contrast, the best-performing New York hospital that
year had an episiotomy rate of 2.5 percent.

While episiotomies are rarely ever medically necessary, doctors may
still perform episiotomies out of habit and convenience since the proce-
dure can shorten the birthing process significantly.* More concerning is
that an investigation by CUNY Graduate School of Journalism found that
episiotomies are frequently performed without consent. ** Further,
evidence shows that Black, Brown, and Indigenous populations are subject
to non-consensual episiotomies at higher rates compared to White
women.Providing information regarding episiotomies to pregnant people
will ensure that they are aware this procedure is a possibility and
understand the risks associated with it. The bill addresses issues of
consent during delivery and enables pregnant people to discuss possible
procedures with their providers and advocate for themselves during
delivery.

This bill directs the Commissioner of Health to establish a formal writ-
ten communication or communications for a maternal health care provider
to provide information to each maternal patient who plans to deliver
vaginally to inform them about risks associated with episiotomies and
how having an episiotomy may impact future pregnancies. By ensuring
women understand the risks and impacts associated with episiotomies
mothers can make more informed and autonomous decisions about their
healthcare.

 
LEGISLATIVE HISTORY:

2021-22: S8455/A9380 referred to women's issues.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall have become a law. Effective immediately, the commissioner of
health shall make regulations and take other actions reasonably neces-
sary to implement this act on that date. * MacLeod, A. (2018).  All
Together Healthy (1st ed.). Douglas & McIntyre. ** Enking, Molly
Cora,"Women are being cut during childbirth without need or consent"
(2018). CUNY Academic Works. https://academicworks.cunv.edu/ai etds/285
***"Giving Voice to Mothers in the US: Experiences of care among people
of color and in community settings for birth" (2019).  Birth Place Lab,
University of British Columbia.